Laryngorhinootologie 2013; 92(12): 797-807
DOI: 10.1055/s-0033-1349085
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Management des T1a Stimmlippenkarzinoms

Management of T1a Vocal Fold Carcinoma
R. Reiter
1   Sektion für Phoniatrie & Pädaudiologie, der Universitäts-HNO-Klinik, Ulm
,
S. Brosch
1   Sektion für Phoniatrie & Pädaudiologie, der Universitäts-HNO-Klinik, Ulm
,
E. Smith
1   Sektion für Phoniatrie & Pädaudiologie, der Universitäts-HNO-Klinik, Ulm
,
A. Pickhard
2   Hals-Nasen-Ohrenklinik, Technischen Universität München, München
› Author Affiliations
Further Information

Publication History

Publication Date:
08 August 2013 (online)

Zusammenfassung

Etwa 2/3 der Larynxkarzinome befallen die Stimmlippen. Der Hauptrisikofaktor hierfür ist Nikotingenuss. Meist gehen sie aus Leukoplakien hervor, die Dysplasien enthalten. Sie werden aufgrund einer Dysphonie in der Regel frühzeitig entdeckt. Mikrostroboskopisch ist ein phonatorischer Stillstand nahezu pathognomonisch für ein Stimmlippenkarzinom. Die Therapie des einseitigen glottischen (T1a) Stimmlippenkarzinoms besteht in der transoralen Laserresektion, die aus onkologischer und funktioneller Sicht gleichwertig wie die primäre Bestrahlung ist. Da lokoregionäre und Fernmetastasen eine Rarität bei einseitigen Stimmlippekarzinomen darstellen, wird bei der Nachsorge laryngos­troboskopisch auf den Lokalbefund besonderer Wert gelegt. Bei suspekten Befunden muss eine bioptische Sicherung erfolgen, um dann ggf. zügig eine Therapie einleiten zu können. Insgesamt hat das T1a Stimmlippenkarzinom eine sehr gute Prognose mit einer 5 Jahres Überlebensrate von nahezu 100%.

Abstract

Management of T1a Vocal Fold Carcinoma

About 2/3 of the larynxcarcinomas affect the vocal chords. The main risk factor is smoking. Carcinomas in this localisation often arise from leukoplakias with dysplasia. A typical symptom is dysphonia. Arrest of vibration in microlaryngostroboscopy is a hint that a carcinoma could be present. Transoral lasercordectomy or radiotherapy show equivalent oncological results and results in quality of voice in the treatment of vocal fold carcinoma (T1a). As lymph node and distant metastasis are very rare, follow-up can concentrate on microlaryngoscopy. In case of a suspicious area on the vocal fold, biopsy of the affected tissue is needed to plan correct treatment. The prognosis of the T1 vocal chord carcinoma is quite good with a 5-year survival rate of almost 100%.

 
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